Perinatal and infant mental health and parenting

Parenting, the mental health and wellbeing of children and the mental health and wellbeing of their families, particularly their parents, are all inter-related. As such, a combined view must be taken of the whole family for the benefit of each of its members, not solely the child or children. 

The perinatal period, defined as the period from conception until the child is one year old, is often a stressful and challenging period for parents. Perinatal mental disorders are the most common complication of child-bearing for women and are known to affect the long-term health of both mother and child. Anxiety and depression affect approximately 20% of expectant and new mothers. The risk of perinatal anxiety and depression increases with life stress and is highest amongst those with low or unpredictable income and home circumstances, those living with abuse or exposed to violence and those who have existing mental ill-health. Maternal suicide remains the leading cause of death between six weeks and a year following the end of pregnancy. 

Among the health consequences of maternal mental illness for the child are negative impacts upon a wide range of facets of their own mental health and wellbeing. Maternal mental illness in the perinatal period has been found to be associated with poorer outcomes for children in terms of emotional difficulties, depression, social development, behavioural problems, insecure attachment and cognitive development. There is also evidence that mental health problems in fathers has impact upon the mental health and wellbeing of children, though there is less research in this area than for maternal mental health. Action to address perinatal mental health problems has been found to have long-term positive impacts and also to be cost-effective. 

Infant mental health is normally defined as the capacity of babies and small children to form close relationships, recognise and express emotions, and explore and learn about their environment. The importance of this period of life for a person’s neurological, psychological, emotional and social development is widely recognised, often referred to as the “first 1000 days” from conception to early infancy. The concept of mental health disorders in infancy is not widely explored and the focus in infant mental health is often on parenting and secure attachment relationships. Attachment refers the tendency of the child to form close emotional bonds, particular with their caregivers, and derive comfort from contact with them. Disorganised attachment, including insecurity and rejection in early life has been found to be an important determinant of the development of social, emotional and mental health problems in childhood and later in life.  

There is high quality evidence on the effectiveness of parenting programmes, from the perinatal period, through infancy and into later childhood and adolescence. Support for parenting is a crucial aspect of a public mental health approach, promoting good mental health and wellbeing at the earliest stages of life to have impacts across the life course.